Functional impairment in outpatients with mental disorders after the 2011 Great East Japan Earthquake

Background: It is generally accepted that functional impairments are found in the course of patients with mental disorders who have exhibited vulnerability to a disaster. However, there has been no study examining post-disaster functional changes among them. The aim of the present study is to evaluate functional changes related to the 2011 Great East Japan Earthquake among patients with mental disorders living in the peripheral area of the earthquake zone, i.e., Tochigi Prefecture just adjacent to Fukushima Prefecture. Methods: A total of 612 outpatients with schizophrenic disorders (n=163), mood disorders (n=299), and neurotic disorders (n=150) were evaluated in terms of their post-disaster functional changes using the function subscale of the Global Assessment of Functioning (GAF-F) assessed before and after the 2011 Great East Japan Earthquake. Results: Seventeen percent of the subjects showed a decline of their GAF-F scores after the disaster, compared to those before the disaster. The frequencies of the declined GAF-F score were 22％ for the patients with neurotic disorders, 19％ for those with mood disorders, and 7％ for those with schizophrenic disorders with a significant difference among the 3 diagnostic groups. In 102 subjects who showed a decline of their GAF-F scores after the disaster, the net changes of the decline of the GAF-F scores after the disaster in patients with mood disorders and those with neurotic disorders were significantly greater than those in patients with schizophrenic disorders, respectively. The multivariate logistic regression analysis revealed that patients with mood disorders (F3) (OR=4.28, 95％ CI=2.03-9.02) and those with neurotic disorders (F4)(OR=4.56, 95％ CI=2.09-9.95) were more than 4 times as likely to decline their GAF-F scores after the disaster than those with schizophrenic disorders (F2). Conclusion: We found that in the peripheral area of the earthquake zone 17％ of the outpatients with mood disorders, neurotic disorders and schizophrenic disorders developed a significant functional decline after the 2011 Great East Japan Earthquake. Patients with mood disorders and neurotic disorders were more vulnerable to the disaster, compared to those with schizophrenic disorders. Close monitoring of the psychiatric conditions of individuals with mental disorders, in particular mood disorders and neurotic disorders, may be of critical importance after a major disaster.